Racial segregation and the distribution of health-related community organizations

by Kathryn Freeman Anderson

Many of us have now heard the pithy phrase: “Your zip code is a better predictor of your health than your genetic code.” But what is it about lines on a map that can be corrosive to your physical being?

I propose that part of understanding this observation is not just examining who the residents are and where people are located, but also where the “stuff” is located. We live in an organizational society. Community organizations and service providers play an important role in a community and can make or break a neighborhood. These include businesses, such as retail and restaurants, non-profit community organizations, such as churches and soccer leagues, and government services, such as social service offices and park spaces.

These are the locations where people access the goods and services that they need, where they work and play, and where they can meet up with other people in public spaces to chat, drink coffee, and hang out. These are the physical spaces that activate our social networks.

Yet, these important places are not evenly distributed across urban space. Some areas have an abundance of community organizations, while others are virtual organizational deserts.

That then begs the question: What types of communities have less “stuff” than other areas?

In particular, I am interested in how racial residential segregation may be related to the distribution of important community services across urban space. Although no longer legal, racial residential segregation remains an important and persistent feature of the American urban landscape.

Why would being separated by neighborhood have such strong consequences for the individuals in those areas?

Sociologists have long pondered this question, and there are generally two main ways of thinking about this problem.

The first perspective holds that racial residential segregation is mainly a problem because it concentrates people of lower socio-economic status into one area. As racial/ethnic minority groups experience a disproportionately high rate of poverty, and as such groups become concentrated, so does poverty and the negative effects of poverty. As it relates to organizations, such areas may then be less likely to have key community services because those service providers may see these areas as unprofitable.

The second perspective argues instead that the racial component is what is central here. In this case, segregation is a system of racial stratification driven by the processes of racism and discrimination. Organizations may then avoid such areas due to a desire to avoid minority communities out of fear/prejudice of the challenges of minority communities.

In essence, these spaces are separate, but they are definitely not equal.

In a recent article, I examine racial residential segregation and distribution of organizations across urban neighborhoods to determine if there is a disparity in access to health-related service providers and community organizations for minority communities. Though I do not test health outcomes here, I suggest that this may help explain the broader links between racial residential segregation and poor health outcomes that other researchers have found in their work.

In this article, I take a broad approach to what constitutes a “health-related” organization. I examine the more obvious types of locations, such as food, physical fitness centers, and a number of health care organizations and services. However, I also examine civic associations, religious congregations, and social services as important sites for community vitality, which could be beneficial to one’s health.

I find that racial residential segregation is linked to a lack of a wide variety of health-related community organizations. What this means is that neighborhoods with a higher concentration and clustering of minority residents have fewer health-promoting organizations. I also find this pattern across the three largest racial/ethnic minority groups in the U.S.: Blacks, Latinos, and Asians (in a few cases), though this pattern is most pronounced for Black segregation.

When adding in poverty and socio-economic factors, this pattern is altered somewhat. For Black segregation, the trend remains and is even bolstered in most cases (with the exception of health care facilities). This provides support for the discrimination perspective.

However, for Latino segregation, in most cases, the statistical association is accounted for with the inclusion of socio-economic factors, especially in the case of health care facilities. This means that for Latino segregated communities, their lack of facilities is largely a result of their socio-economic resources. This provides support for the socio-economic perspective.

In general, what this research shows is that minority concentrated areas are less likely to have a number of important health-promoting organizations and service providers in their communities.

This means that these communities are at a disadvantage by not having access to such service providers in close proximity to their communities. This of course does not mean that they cannot utilize such facilities, but rather that it will be more difficult and costly for the people in these communities to do so.

An obvious solution or response to this problem is to de-segregate urban communities. Given that this is the root of the problem, this would be the most direct solution. However, as history has proven this to be a difficult task, it may not be that easy to achieve in our current political climate.

Alternatively, what this research suggests is that another way to combat these problems would be to improve access to health-related services and facilities in segregated communities. Local governments or community-based initiatives could provide incentives for organizational movement into such communities.